Modic Changes (MCs) Associated with Endplate Sclerosis Can Prevent Cage Subsidence in Oblique Lumbar Interbody Fusion (OLIF) Stand -Alone
Modic Changes (MCs) Associated with Endplate Sclerosis Can Prevent Cage Subsidence in Oblique Lumbar Interbody Fusion (OLIF) Stand -Alone
复制标题
与终板硬化相关的 Modic 变化 (MC) 可防止斜腰椎椎间融合术 (OLIF) 独立中的融合器下沉
DOI：
10.1016/j.wneu.2020.02.047
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发表时间：
2020-06-01
影响因子：
2
通讯作者：
Zhao, Fengdong
中科院分区：
文献类型：
--
作者：
Liu, Junhui;Ding, Wenyuan;Zhao, Fengdong
目的探讨Modic变化（MCs）与终板硬化的关系；并探讨MCs和终板硬化对斜腰椎椎体间融合术（OLIF）单独椎体间固定的影响。方法纳入2015年8月至2017年8月期间单独行OLIF的住院患者78例。所有患者均行计算机断层扫描（CT）和磁共振成像。评估MCs的存在和类型。通过矢状面重建CT图像评估终板硬化。在1个月、3个月、6个月和12个月的随访中评估笼沉降。结果78例患者中，92个椎间盘行OLIF，无后路内固定；92例中有32例（34.8%）患有MCs。I型、II型和III型MCs分别出现在10例（10.9%）、19例（20.7%）和3例（3.2%）终板中。32例MCs终板中，10例（31.3%）在CT图像上显示硬化证据，其中I型MCs终板中2例（20%），II型终板中5例（26.3%），III型终板中3例（100%）。在60例无MCs终板中，5例（8.3%）有硬化迹象。无MCs组的笼沉降率高于MCs组（P<0.01）。我们发现MCs组只有1例笼子下沉（n = 32），被归类为MCs I型，而无MCs组有6例笼子下沉（n = 60）。硬化和无硬化终板的Hounsfield单位比分别为2.2±0.3和1.1±0.1。硬化终板组无cage下沉（n = 15），无硬化终板组有7例cage下沉（n = 77）。结论mcs合并终板硬化可预防OLIF患者笼型下沉。
ObjectiveTo investigate the association between Modic changes (MCs) and endplate sclerosis; and to investigate the effect of MCs and endplate sclerosis on cage subsidence in oblique lumbar interbody fusion (OLIF) stand-alone.MethodsWe included 78 inpatients who underwent OLIF stand-alone from August 2015 to August 2017. All patients underwent computed tomography (CT) and magnetic resonance imaging. The presence and the types of MCs were assessed. Endplate sclerosis was evaluated from sagittally reconstructed CT images. Cage subsidence was evaluated at the 1-, 3-, 6-, and 12-month follow-up.ResultsOf 78 patients, 92 discs underwent OLIF without posterior instrumentation; 32 of 92 (34.8%) had MCs. Type I, II, and III MCs were seen in 10 (10.9%), 19 (20.7%), and 3 (3.2%) endplates, respectively. Among 32 endplates with MCs, 10 (31.3%) showed evidence of sclerosis on CT images, including 2 of 10 endplates (20%) with type I MCs, 5 of 19 (26.3%) with type II, and 3 of 3 (100%) with type III. Among 60 endplates without MCs, 5 (8.3%) showed evidence of sclerosis. Cage subsidence rate in the no-MCs group was higher than that in the MCs group (P<0.01). We found only 1 case of cage subsidence in the MCs group (n = 32), which was classified as MCs type I, whereas 6 cases of cage subsidence were observed in the no-MCs group (n = 60). Hounsfield unit ratios for sclerotic and no-sclerotic endplates were 2.2 ± 0.3 and 1.1 ± 0.1, respectively. No subsidence of cage was found in the sclerotic endplates group (n = 15), whereas 7 cases of cage subsidence were found in the no-sclerotic group (n = 77).ConclusionMCs associated with endplate sclerosis can prevent cage subsidence in OLIF stand-alone.